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Cardio Block > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

The majority of heart disease in children is

A

Congenital (5 to 8 of every 1000 live births)

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2
Q

The three causes of congenital heart disease

A

Genetic, Environmental, multifactorial (combo of genetic and environmental)
Multifactorial makes up the majority

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3
Q

What does congenital mean

A

A disease that exists at birth or develops during the first month of life.

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4
Q

Syndromes with Congenital Heart Disease

A

Down, Turner, Marfan, Noonan, 18, 13,

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5
Q

Infections that can lead to congenital heart disease

A

Rubella

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6
Q

Diseases that lead to congenital heart disease

A

PKU

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7
Q

Drugs that lead to CHD

A

Thalidomide, Accutane, Trimethadione

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8
Q

Toxins that lead to CHD

A

ALcohol and cocaine

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9
Q

One mechanism that can lead to CHD is altered flow patterns during cardiac development

A

true

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10
Q

Decreased right heart flow during cardiac development leads to

A

Tricuspid Atresia (TAT), Pulmonary Stenosis Valvular (PSV), Atrial septal defect (ASD)

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11
Q

Decreased Left Heart Flow

A

Atrial Septal Defect (ASD), Coarctation of the Aorta, Mitral Atresia (MAT)

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12
Q

At birth, systemic resistance does what?

A

Increases

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13
Q

At birth, pulmonary resistance does what?

A

decreases (lungs expand)

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14
Q

At 24 hours, pulmonary resistance is (blank) of systemic resistance

A

one half

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15
Q

Most common CHD

A

Ventricular septal defect…by a long shot.

Then atrial septal defect, pulmonary stenosis

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16
Q

The various CHD abnormalities can be grouped into three categories. They are

A

abnormalities causing a Left to right shunt, Right to left shunt, and obstruction

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17
Q

Dusky blueness of skin. What shunt is it?

A

Right to left shunt. blood avoids pulmonary circulation

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18
Q

Left to right shunt

A

Expose the low pressure, low reisistnace pulmonary vasculature to increased volume and increased pressure. Leads to increased pulmonary vascular resistance which leads to right heart hypertrophy and eventually failure. With time, this increased resistance can cause reversal of the shunt to right to left.

19
Q

Atresia

A

Complete obstruction

20
Q

Most common shunt

A

Left to right…ASDs, VSDs, PDA (patent ductus arteriosus)

21
Q

What does the Foramen ovale do in fetal circulation

A

Allows blood to flow from the right atrium to the left. Bypasses the fetal lungs.

22
Q

pulmonary hypertension associated with

A

Left to right shunt. This pulm HTN can lead to a reversal of shunting and thus cyanosis. Seen earlier and more frequently at this severity in VSDs than ASDs.

23
Q

Whats the point of the ductus arteriosus during intrauterine life?

A

Its like a bridge between the pulmonary artery and the aorta. It permits blood flow from the pulm arteries to the aorta so that blood can bypass the unoxygenated lungs.

24
Q

When is the ductus usually obliterated

A

First few months of life

25
Q

PDA characteristics.

A

High pressure left to right shunts. Sounds like machinery in systole

26
Q

Cyanotic CHD (right to left shunt) associated with what conditions

A

tetralogy of fallot and transposition of the great vessels

27
Q

Physiologic murmurs

A

PPS, PFO

28
Q

Physiologic murmurs in toddlers

A

Still’s, venous hum, pulmonary flow, carotid bruit

29
Q

Adult phyiologic murmurs

A

Mammary SOufle

30
Q

Are Physiologic murmurs ver in diastole

A

NO….only systole

31
Q

Are physiologic murmurs ever associated witha thrill

A

no

32
Q

Physiologic murmurs localized to left sternal border

A

yes

33
Q

AV valve murmur during systole

A

regurgitation…mi, tri, sys, regurg

34
Q

AV valve during diastole

A

Stenosis

35
Q

Semilunar valves during sys

A

stenosis

36
Q

Semilunar during diastole

A

regurg

37
Q

Murmurs of relative stenosis occur when?

A

When abnormally large amounts of blood flow pass across a structurally normal valve.

38
Q

When is cyanosis typically observed

A

When the concentration of desaturated Hgb is above 4 gm/dl

39
Q

Cardiac vs. non cardiac causes of cyanosis

A

Cardiac cause = perfusion of systemic circulation with desaturated blood.

40
Q

Non-cardiac causes of cyanosis

A

Peripheral vasoconstriction, desaturation of pulmonary venous blood
Desaturation of pulmonary venous blood (hypoventilation, pneumonia, pneumothorax)

41
Q

Hyperoxia test tells you what

A

Whether the Cyanosis is a problem of the heart or a problem of the lungs. Administer 100% FiO2 by hood or ETT. If PO2 is less than 100, the probability of congenital heart disease goes way up.

42
Q

Cyanotic heart defects

A

Tunk, tran, tri, tet, tot
Trunkus arteriosus, transposition of the great arteries, Tricuspid atresisa,
Tetralogy of Follot
Total anomalous pulmonary venous return

43
Q

Is an unrestrictive VSD in a newborn likely associated with a murmur

A

no

44
Q

Unrestrictive VSD in a 2 month old likely associated with what?

A

Systolic murmur and diastolic rumble

Cardio Block (42 decks)

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